不同类型支架鼻整形术的回顾性研究  

Retrospective study of different types of rhinoplasty frameworks

作　　者：邓毅文 王先成[1] 孙杨[1] 杨开 乔治华 靳乐微 晏权锭 李春洁 熊祥[1] 孟宪熙 李文波 Deng Yiwen;Wang Xiancheng;Sun Yang;Yang Kai;Qiao Zhihua;Jin Lewei;Yan Quanding;Li Chunjie;Xiong Xiang;Meng Xianxi;Li Wenbo(Department of Plastic and Aesthetic(Burn)Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院整形美容(烧伤)外科,长沙410011

出　　处：《中华整形外科杂志》2023年第3期293-302,共10页Chinese Journal of Plastic Surgery

基　　金：湖南省自然科学基金(2021JJ30034);湖南省卫生健康委员会重点项目(20200048);湘雅医学大数据系统建设项目(面部整形整容临床大数据系统)。

摘　　要：目的:探讨一体化、1+1型、2+1型、4+1型、Y型鼻整形支架的结构特点、稳定性及术后效果评估。方法:回顾性分析2019年2月至2020年11月,中南大学湘雅二医院整形美容(烧伤)外科收治的鼻整形患者资料。依据采用的鼻整形支架的类型分为一体化组、1+1型组、2+1型组、4+1型组、Y型组。通过测量患者术后1、12个月鼻尖突出度和鼻唇角评估鼻支架的稳定性,术后随访患者并发症的发生情况和患者满意度,各组间术后1个月与12个月的鼻尖突出度差值及鼻唇角差值采用单因素方差分析或Kruskal-Waliis H检验,组间两两比较采用Bonferroni法或Nemenyi检验,P<0.05为差异有统计学意义。结果:共纳入201例患者,男18例,女183例,年龄(26.6±5.9)岁(18~46岁),2+1型组34例、一体化组45例、1+1型组45例、4+1型组35例、Y型组42例。术后随访12~21个月,2+1型组1例患者术后92 d出现鼻部感染;1+1型组1例患者术后6个月出现鼻小柱轻微歪斜,3例患者术后12个月出现明显的鼻尖下旋;Y型组4例患者术后12个月出现明显鼻尖上旋;余2组患者未发现并发症。鼻尖突出度方面,2+1型组、一体化组、1+1型组、4+1型组、Y型组术后12月与术后1月鼻尖突出度差值的中位数分别为-0.08 cm、-0.09 cm、-0.20 cm、-0.10 cm、-0.17 cm。5组间鼻尖突出度差值比较,差异有统计学意义(P<0.01);2+1型组分别与1+1型组、Y型组比较,差异均具有统计学意义(P均<0.05);4+1型组分别与1+1型组、Y型组比较,差异均具有统计学意义(P均<0.05);一体化组分别与1+1型、Y型组比较,差异均具有统计学意义(P均<0.05);Y型鼻支架与1+1型组比较,差异具有统计学意义(P<0.05)。鼻唇角方面,2+1型组、一体化组、1+1型组、4+1型组、Y型组术后12月与术后1月鼻唇角差值的中位数分别为:-4.20°、-3.80°、-6.50°、-4.10°、-6.35°。5组间鼻唇角差值比较,差异有统计学意义(P<0.01);2+1型组分别与1+1型、Y型�Objective To evaluate the structural features,stability and postoperative effect of integrated framework,1+1 framework,2+1 framework,4+1 framework,and Y-shaped nasal framework.Methods A retrospective analysis was performed based on the clinical data of patients underwent in Department of Plastic and Aesthetic(Burn)Surgery,the Second Xiangya Hospital,Central South University from February 2019 to November 2020.According to rhinoplasty framework,the patients were divided into integrated framework group,1+1 framework group,2+1 framework group,4+1 framework group,and Y-shaped framework group.Based on the principle of plane photography,the stability of the nasal framework was evaluated by measuring the nasal tip projection and the nasolabial angle 1 month after surgery,and 12 months after surgery.The satisfaction of patients and the incidence of postoperative complications were collected.The difference in nasolabial angle and nasal tip projection data of postoperation 1 month and postoperative 12 months among each group were analyzed by one-way analysis vaniance or Kruskal-Waliis H test.Bonferroni test or Nemenyi test was used for pairwise comparison between groups.P<0.05 was considered statistically significant.Results A total of 201 patients(18 males and 183 females,aged 18-46 years,average aged 26.6±5.9 years)were included in this study and followed up for 12-21 months.There were 45 patients in the integrated framework group,45 patients in the 1+1 framework group,34 patients in the 2+1 framework group,35 patients in the 4+1 framework group,and 42 patients in the Y-shaped framework group.Four patients with Y-shaped framework had significant nasal tip supination 12 months after surgery.Among the patients with 1+1 framework,1 patient showed slight columella distortion 6 months after surgery,and 3 patients showed significant nasal tip subrotation 12 months after surgery.One patient in 2+1 framework group developed nasal infection 92 days after surgery.No complications were found in other groups during follow-up.In ter

关 键 词：鼻成形术 鼻支架 分类 肋软骨 耳软骨 移植物 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]